RhAPPcast: The Safety Conversation: Upadacitinib in the Treatment of GCA

In this final episode of the GCA Fireside Chat series on RhAPPcast, host Amanda Mixon, PA-C, is joined again by Naomi Amudala, CRNP, and Jessica Farrell, PharmD, to explore the critical risk-benefit considerations of upadacitinib in the treatment of giant cell arteritis (GCA). With upadacitinib gaining FDA approval, understanding its safety profile is essential for providers treating an older, high-risk patient population. The discussion breaks down results from the SELECT-GCA trial, covering baseline patient characteristics, major adverse cardiovascular events (MACE), venous thromboembolism (VTE), infection risk—including herpes zoster—and how to stratify patients appropriately for therapy. The experts highlight key differences between GCA and RA populations, compare upadacitinib risks to the well-documented toxicities of long-term corticosteroid use, and provide real-world perspectives on lab monitoring, vaccination, and patient counseling. This episode helps clinicians feel more confident in prescribing steroid-sparing therapy while keeping patient safety at the forefront of decision-making.